Is duloxetine (Cymbalta) 30 mg available?

Duloxetine 30 mg Availability

Yes, duloxetine 30 mg is available as a delayed-release capsule. 1 According to the FDA drug label, duloxetine 30 mg comes as a blue opaque/white opaque, size '3' hard gelatin capsule filled with white to off-white pellets and imprinted with 'X' on the blue opaque cap and '02' on the white opaque body with black ink.

Dosage Forms and Clinical Use

• Duloxetine is available in three strengths: 20 mg, 30 mg, and 60 mg delayed-release capsules 1
• The 30 mg dose is commonly used as a starting dose for several conditions:
  • For neuropathic pain management, 30 mg once daily is recommended for the first week before increasing to 60 mg once daily to reduce the risk of nausea 2
  • For generalized anxiety disorder in geriatric patients, 30 mg once daily is recommended for 2 weeks before considering an increase to 60 mg daily 1
  • For pediatric patients (7-17 years) with generalized anxiety disorder, 30 mg once daily is the initial dose 1

Administration Considerations

• Duloxetine delayed-release capsules should be taken orally and swallowed whole 1
• The capsules should not be chewed, crushed, opened, or sprinkled on food as these actions might affect the enteric coating 1
• It can be taken with or without food 1, 3

Clinical Applications

• Duloxetine is FDA-approved for several conditions:
  • Major depressive disorder 1, 4
  • Generalized anxiety disorder 1, 3
  • Diabetic peripheral neuropathic pain 1, 4, 5
  • Fibromyalgia 5
  • Chronic musculoskeletal pain 6

Dosing Considerations

• For neuropathic pain, the recommended dosing strategy is:
  • Start with 30 mg once daily for 1 week to reduce the risk of nausea 2
  • Increase to 60 mg once daily after 1 week 2
  • Maximum dose is 60 mg twice daily, though 60 mg once daily appears to be as effective as higher doses 2
• For osteoarthritis pain, duloxetine should be initiated at doses of 30 mg/day or more and increased to a goal of 60 mg/day 2

Common Side Effects

• Nausea (most common adverse effect, can be reduced by starting at 30 mg) 2, 3
• Dry mouth, headache, constipation, dizziness, and fatigue 3
• Somnolence, decreased libido 2
• Acid reflux (rare, reported in only 1.38% of patients) 6

Important Precautions

• Duloxetine should be tapered when discontinuing treatment to avoid withdrawal symptoms 2, 3
• Dosage adjustment is required for patients with renal impairment (creatinine clearance <30 mL/min) 2
• Contraindicated in patients with severe hepatic impairment 2
• Does not typically produce clinically important electrocardiographic or blood pressure changes 2

The 30 mg dose of duloxetine serves as an important starting dose for most indications, helping to minimize side effects while initiating treatment before potentially increasing to the target therapeutic dose of 60 mg daily for most conditions.